Percent of men having commercial sex in last year

Percent of men having commercial sex in last year

Percent of men having commercial sex in last year

The percent of men reporting sex with a sex worker in the last 12 months

This indicator is intended only for countries with well-defined populations of sex workers. (See below.) In general population surveys or in specialized surveys among groups of men who fit the profile of clients of sex workers (the military, truck drivers, among others), men are asked directly if they had sex with a sex worker in the previous 12 months.

Although a given country may have several different types of definable sex workers, each with different perceived levels of risk, evaluators can combine all these groups into an indicator of commercial sex use for monitoring and evaluation purposes.

This indicator is calculated as:

(Number of men who report having sex with a sex worker in the past 12 months / Total number of male respondents) x 100

In some countries, evaluators have collected this indicator in the past using only sexually active men (rather than all male respondents) as the denominator. To maintain valid trend data, we recommend calculating this indicator both ways (using only sexually active men and using all men in the denominator) over a period of several years.

Data Requirement(s):

Self-reported data from survey respondents

UNAIDS general population survey; DHS AIDS Module; FHI BSS (adult)

In concentrated epidemics, sexual mixing between groups with a high likelihood of infection and the general population is of central interest. In heterosexual concentrated epidemics, the initial focal point of infection is among sex workers and their clients. Those clients then spread infection to their wives and girlfriends in the general population, as well as to other sex workers. In such situations, AIDS programs often focus on trying to reduce the proportion of men having sex with sex workers, as well as increasing condom use in these encounters. This indicator measures progress towards the first of these goals.

This indicator is useful in concentrated heterosexual epidemics in countries where commercial sex (and especially brothel-based sex) is common, and where a “prostitute” has a clearly defined role. Thus the indicator is most likely to be used in parts of the world where commercial sex has played a dominant role in the epidemiology of HIV (e.g., many countries in Asia).

Attempts to collect and analyze data using a wider definition of commercial sex (questions such as “Have you given or received money or gifts in exchange for sex?”) have not yielded useful information. In epidemic terms, sex workers are of interest because they have a high turnover of partners and therefore have a high probability of being exposed to infection and passing on infection. In many cultures, the high number of partners is true of only a fraction of the people who have “received money or gifts in exchange for sex.” If no locally specific term for prostitution exists, the chances are that this indicator is not relevant to the program and should not be used.

The indicator is also of limited use in very high prevalence epidemics, because differences in risk associated with sex with a sex worker compared with any other casual partner may be unsubstantial.

One may construct a similar indicator for clients of male sex workers in special surveys of men who have sex with men.

HIV/AIDS